The maximum safe local anaesthesia doses are as follows:

Drug

Maximum safe dose

Lidocaine

3mg/kg

Lidocaine (with adrenaline/epinephrine)

7mg/kg

Bupivacaine

2mg/kg

Bupivacaine (with adrenaline/epinephrine)

2mg/kg

Levobupivacaine

2mg/kg

ADRENALINE WITH ARTICAINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Injection (adrenaline 1 in 100,000 (22 micrograms), articaine 88mg/2·2mL cartridge)

BUPIVACAINE

Important: Therapy notes


Local anaesthesia for insertion and post insertion of chest drain.

Important: Formulation and dosage details

Formulation:

Infusion (epidural) 250mg/250mL (0·1%) in sodium chloride 0·9%

Important: Formulation and dosage details

Formulation:

Solution for injection 0.25% 10ml ampoules

BUPIVACAINE WITH GLUCOSE

Important: Therapy notes

For spinal anaesthesia.

Important: Formulation and dosage details

Formulation:

Solution for injection (Marcain Heavy®) 0.5%

LEVOBUPIVACAINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for injection 25mg/10mL, 50mg/10mL, 75mg/10mL

Important: Formulation and dosage details

Formulation:

Epidural infusion 250mg/200mL (0·125%)

LEVOBUPIVACAINE 0·1% WITH FENTANYL 2 MICROGRAMS/ML

Important: Formulation and dosage details

Formulation:

Infusion in sodium chloride 0·9% (250mL) unlicensed

LIDOCAINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for injection 1% (50mg/5mL, 100mg/10mL, 200mg/20mL), 2% (100mg/5mL)

LIDOCAINE WITH ADRENALINE

Important: Therapy notes

There is a known shortage with this product. See: Medicines shortage log (NHS Highland intranet access required)

Important: Formulation and dosage details

Formulation:

Solution for injection (Xylocaine®)  (lidocaine 1%, adrenaline 1 in 200,000), (lidocaine 2%, adrenaline 1 in 200,000)

MEPIVACAINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for injection cartridge 3%

PRILOCAINE HYDROCHLORIDE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for injection 1% 500mg/50mL

Important: Formulation and dosage details

Formulation:

Hyperbaric solution for injection 2% (hospital use only - restricted to anaesthetists)

Dosage:

As per SMC 665/10: spinal anaesthesia.
SMC restriction: for use in spinal anaesthesia in ambulatory surgery settings such as day surgery units.

Editorial Information

Document Id: F020